The Optometric Minute

Who Handles the Money in Your Practice?

Dec. 23, 2015

Ryan Powell, OD, the owner of Insight Eyecare Specialties, in the Kansas City, Mo., metro area, and Matthew Alpert, OD, owner of Alpert Vision Care, in Woodland Hills, Calif., and Wink Optometry in Calabasas, Calif., say multiple checks and balances are needed to monitor practice finances. They advise never relying on one person, no matter how trusted, to manage the money coming into your practice, and as practice owner, to periodically match the billing and invoices to the money in your account.

Assume the Worst: Check and Re-Check
Maintain Control Over Your Finances

Ryan Powell, OD, the owner of Insight Eyecare Specialties, says he has heard too many horror stories of a trusted employee embezzling money from a practice to let his guard down.

“We have a couple checks and balances with cash,” he says. The practice has an internal courier who pulls the balance sheets and compares the cash deposits to the payment posted to patient EHR files. The practice also uses an in-house bookkeeper for its accounts payable. “The best method we’ve come up with to keep our thumb on everything is scrubbing your QuickBooks, and periodically taking a look at where your checks are going,” says Dr. Powell.

It also helps as practice owner to pull up pictures of checks of payment from your practice, and if you aren’t familiar with the business the check is being sent to, to do research, pulling up the invoice where the payment originated from. “We scan all of our invoices in, so we can pull those up for our QuickBooks if we want to compare them to our checks.”

Dr. Powell says he likes, and has faith in, his practice’s bookkeeper, but he knows that no one is infallible: “She’s a fantastic person, she’s a family friend of one of our doctors, and I put a lot of trust in her, but I still would suggest: assume the worst.”

Matthew Alpert, OD, owner of Alpert Vision Care, and Wink Optometry, recommends that practice owners handle final bills themselves. “I handle the money, I pay the final bills, and I handle the QuickBooks,” he says.

Dr. Alpert says his office is set up with a front office that handles receipts, and a back office with an insurance biller, who handles reconciliation to make sure bills, and money coming into the practice, match. “I look over the stats at the end of the month,” says Dr. Alpert. “It’s too easy for slippage, or something, to happen, and I want to make sure I stay on top of it.”

Cash only represents 1-2 percent of the total monthly receipts, but Dr. Alpert reconciles it himself at the end of the day, and personally ensures it is deposited into the bank by the next morning.

The practice has just two locations now, but plans to grow into more locations in the future. At that time, Dr. Alpert says it will be necessary to hire a professional office manager. “You can recruit from within, but at that point, if you’re up to four or five locations, you’re looking at a professional business person to step in and help you,” he says.

In the meantime, Dr. Alpert says he never wants to become reliant on one person to review the practice’s finances. “I want more than one person reviewing receipts when they come in,” he says. “It has to be matched and balanced by two separate people, and those are not people who sit next to each other in the office. Those are people who are not necessarily correlated in initial job responsibilities [with financial management], but at the end of the day, that’s part of their responsibilities.”

Ryan Powell, OD, owns Insight Eyecare Specialties, located in the Kansas City, Mo., metro area . To contact him: drpowell@ieseyecare.com

Matthew Alpert, OD, is the owner of Alpert Vision Care, in Woodland Hills, Calif., and Wink Optometry in Calabasas, Calif. To contact him: drmalpert@aol.com

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